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Condominium Owner or Tenant Insurance quote form |
- Available to residents of British Columbia only
- Please try to fill out all columns as detailed as possible. You may save more on your insurance premium.
- We will reply to you by e-mail or phone within 1 or 2 business day(s).
- Privacy Policy
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| * Mandatory Field |
| 1. Type of Policy |
| * |
a) Tenant |
| * | b) Condo owner - Owner occupied |
| * | c) Condo owner - Rented to other |
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| 2. Applicant’s Name, Date of Birth, Occupation (Age discount may apply) |
| First Name * |
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| Last Name * |
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| Date of Birth * |
Date
Month
Year
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| Occupation * |
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| 3. Co-Applicant’s (Spouse’s or Partner’s) Name, Date of Birth, Occupation (Age discount may apply) |
| First Name |
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| Last Name |
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| Date of Birth |
Date
Month
Year
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| Occupation | |
| Relationship to Applicant | |
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| 4. Address (Risk Location) and Date moved in |
Room No * |
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| Street No * |
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| Street Name * |
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| City Name * |
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| Postal Code * |
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| Telephone Number * |
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| E-mail Address * |
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| Confirm E-mail Address * |
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| Moved in on * |
Date
Month
Year
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| 5. Past Unreported Claim (Fire, Theft, Water Damage etc) |
| a) * |
None |
| b) * |
Yes. If Yes, What happened, When, Where, Damaged amount
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| 6. Past Reported Claim and Details |
a) * |
None |
| b) * |
Yes. If Yes, What happened, When, Where, Claimed amount, Status of the claim
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| 7. Previous (Current) Insurance |
| a) * |
None. If No, specify the reason why you are looking for one now.
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| b) * |
Yes, policy expiry date, specify year(s) of claim free period, total number of years insured and amount of deductible.
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| c) * |
Previously cancelled, declined or refused to renew by any insurer. If Yes, Why?
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| 8. Year that Building was built (ex. 2005) |
| * | |
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| 9. Building’s Total Floors (How many stories does it have?) |
| * |
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| 10. Number of Units(Apartments) in the Building |
| * | unit(s) |
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| 11. Building’s Construction |
| * | Frame |
| * | Fire Resistive |
| * |
Other (Please specify below)
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| 12. Commercial Occupancy in the Building (Restaurant, Store, etc. ), if yes, |
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| 13. Room Size and Details |
| * |
Sq. |
| Choose one * |
Studio, 1 bedroom, 1 bedroom + den |
| 2 bedroom, 2 bedroom + den |
| 3 bedroom |
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| 14. Heating system |
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Electric |
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Gas furnace forced hot air |
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Gas furnace radiant hot water |
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Other (Please specify below)
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| 15. Security in the Suite |
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Sprinkler in your unit |
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Local Alarm (Burgler) in your unit (not at the building) |
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Monitored Alarm (Burgler) in your unit (not at the building) |
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| 16. Contents Amount (*note: minimum $30,000 for Tenants / minimum $40,000 for Condo-owners) |
| * |
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| 17. Optional coverage |
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Earthquake |
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Sewer backup |
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| 18. Mortgage (If Applicable) |
| * |
No |
| * |
Yes |
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| 19. Additional Liability Exposure Information |
| Share with Non-Family Member(s) * |
Yes How many?
No |
| Rooms Rented to Others* |
Yes How many boarders?
No |
| Incidental Office Use * |
Yes How often?
No |
| Business Operations at this Location * |
Yes What kind of operation?
No |
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| 20. Other information |
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